Influence of Specific Health Guidance on the Consultation Rate of Metabolic-Related Diseases

In Japan, national health expenditure is increasing each year. In particular, medical care costs for the elderly is growing at the rate of about 9% annually alongside the rapid increase of the aging population. In Japan, the specific health checkup and specific health guidance were implemented in 2008 to reduce medical costs in the medium to long term by preventing metabolic syndrome. To evaluate the influence of Specific Health Guidance on medical costs for metabolic-related or other diseases, we conducted propensity score matching and compared between those who received the Health Guidance and those who did not. The two groups were extracted from those with zero outpatient medical expenses for the five months prior to the checkup. The following were selected as variables for matching: gender, age, BMI, abdominal circumference, systolic blood pressure, HbA1c, total cholesterol, urinary protein, smoking/nonsmoking, hoping/not hoping for Health Guidance, and willing/not willing to improve one’s lifestyle habits. Finally, 50 one-to-one matches were performed between the intervention and control groups. The results of the Tobit regression analysis showed that Health Guidance significantly lowered metabolic-related medical expenses for the 26 months. However, for other diseases, no significant difference for medical expenses was evident between the two groups. The consultation rate of the intervention group after 12 months was 28% and 46% for the control group. The results suggest that the Specific Health Guidance in Japan reduced outpatient consultation for metabolic-related diseases.